Department of Microbiology, Gulhane Military Medical Academy, Ankara, Turkey,
Mycopathologia. 2011 Nov;172(5):397-405. doi: 10.1007/s11046-011-9449-z. Epub 2011 Jul 15.
Mucormycosis (Zygomycosis) is a rare, invasive, opportunistic fungal infection of the paranasal sinuses, caused by a fungus of the order Mucorales. We report a case of rhinoorbital mucormycosis caused by Rhizopus oryzae in an acute lymphoblastic leukemia patient and review the 79 Mucormycosis cases reported in the last decade from Turkey. In our case, the diagnosis was made with endoscopic appearance, computerized tomography of the paranasal sinuses, and culture of the surgical materials. Following aggressive surgical debridement and parenteral amphotericin B therapy, the patient recovered completely. In Turkish literature, rhinocerebral manifestations were the most common form of the mucormycosis (64 cases), followed by pulmonary form (6 cases). The most common risk factor was hematologic malignancies (32 cases) and diabetes mellitus (32 cases), similar to those reported from the rest of the world. The etiologic agents responsible for the review cases were Rhizopus sp., Mucor spp., Rhizomucor spp., Rhizopus oryzae, Mucor circinelloides, and Lichtheimia corymbifera. Although various treatment modalities were used, amphotericin B was the mainstay of therapy. Mortality rate was found to be 49.4% in review cases. It seems that strong clinical suspicion and early diagnosis, along with aggressive antifungal therapy and endoscopic sinus surgery, have great importance for better prognosis in mucormycosis.
毛霉病（接合菌病）是一种罕见的、侵袭性的、机会性的鼻窦真菌感染，由毛霉目真菌引起。我们报告了一例由米根霉引起的急性淋巴细胞白血病患者的鼻眶毛霉病，并回顾了过去十年来自土耳其的 79 例毛霉病病例。在我们的病例中，诊断是通过内镜表现、鼻窦计算机断层扫描和手术材料培养得出的。在进行积极的手术清创和静脉注射两性霉素 B 治疗后，患者完全康复。在土耳其文献中，鼻颅表现是毛霉病最常见的形式（64 例），其次是肺部形式（6 例）。最常见的危险因素是血液恶性肿瘤（32 例）和糖尿病（32 例），与世界其他地区报告的情况相似。导致本次回顾病例的病原体包括根霉属、毛霉属、根毛霉属、米根霉、卷枝毛霉和珊瑚状枝孢霉。尽管使用了各种治疗方法，但两性霉素 B 是主要的治疗方法。回顾病例的死亡率为 49.4%。看来，强烈的临床怀疑和早期诊断，以及积极的抗真菌治疗和内镜鼻窦手术，对毛霉病的预后有重要意义。
